Digital Commons Network^™

The Hemostatic Effects Of Acute Exposure To Colored Cornstarch Powder During A 5k Run, Robert C. Allsbrook

Senior Honors Projects, 2010-2019

PURPOSE: To examine the acute hemostatic effects of particulate matter (PM) in the form of colored corn starch powder during a 5 kilometer race. METHODS: 10 recreationally active adults completed two 5k runs, one with color and one without color. 10 mL blood samples were taken 6 hours prior to the trial and immediately following the trial. PAI-1 activity, FVIII antigen, and tPA activity were measured using an ELISA. RESULTS: No significant main effects or interaction effects (P<0.05) were observed among any of the variables although a trend (P = 0.082) was observed for increased PAI-1 activity during exercise in the color condition. CONCLUSIONS: There is a trend towards increased PAI-1 activity levels during exercise during color runs that could be due to increased inflammation. Furthermore, the lack of increased FVIII:ag and tPA activity suggests that the intensity of the exercise may not have been adequate and further research should be conducted in this area.

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Juvenile Idiopathic Arthritis: A Systematic Review Of Occupational Therapy Interventions, Meredith L. Aja, Katie L. Cole, Trenton S. Warning

Pediatrics

Background: The purpose of this systematic review is to describe the current role of occupational therapy (OT) in the treatment of Juvenile Idiopathic Arthritis (JIA). JIA is an umbrella term that encompasses six subtypes of the disease. JIA is one of the most common childhood chronic diseases and can be accompanied by symptoms such as pain, stiffness, and loss of function, as well as psychosocial impacts. JIA participants generally receive pharmacological treatment, but less commonly receive therapeutic interventions to help reduce symptoms. Individualized treatment plans are necessary for clients with JIA due to the diverse nature of the disease. …

The Role Of Scapular Morphology In Reverse Shoulder Arthroplasty, Ashish Gupta

Electronic Thesis and Dissertation Repository

Baseplate fixation in a reverse shoulder arthroplasty depends on adequate bone stock. In cases of severe glenoid bone loss and revision shoulder arthroplasty, deficiency of the glenoid vault compels the surgeon to attain screw fixation in the three columns of the scapula. The relationship of these columns demonstrated that the coracoid is closer to the lateral scapular pillar in females than in males. Significant gender dimorphism exists between the orientations of the three columns. The gender dimorphism is further evaluated by anthropometric measurements of the scapular body and the glenoid. The clinical significance lies in the ability to reconstruct the …

Paediatric Surgical Outcomes Across Ontario, Damian Dylkowski

Electronic Thesis and Dissertation Repository

BACKGROUND: The purpose of this study was to determine the volume of three complex paediatric procedures at the tertiary care centres in Ontario over the last 20 years in three disciplines, analyze outcomes and explore the possibility of an outcome volume relationship.

METHODS: A population based cohort study of patients undergoing TEF repair, Pyeloplasty and V-P shunt insertion at 4 paediatric centres in Ontario between 1993 and 2013 was carried out. Administrative data sets were linked using unique encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences (ICES).

RESULTS: In TEF repair and Pyeloplasty, there was significant difference …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Post-Concussion Experiences Of Collegiate Student-Athletes, Kaitlin Iris Singer

Doctoral Dissertations

Sports-related concussions are a major public health concern affecting a significant number of collegiate student-athletes. Medical and public health research has addressed every aspect of concussion management processes including concussion education, medical diagnosis, recovery, and returning to sport and classroom. This research has led to several best-practices for concussion management. Since 2010, the NCAA has mandated that its member institutions maintain concussion management policies and procedures. However, the current recommendations, based primarily on medical research, have been found in quantitative studies of the behaviors and practices of athletic trainers, coaches, and student-athletes to be ineffective. To date, no studies have …

Regulatory Mechanisms In Borrelia Burgdorferi-Induced Arthritis, Emily Siebers Hansen

Theses and Dissertations

Lyme arthritis is a common symptom of Lyme borreliosis that involves inflammation of the synovial joints. Elucidating the immune events involved in Lyme arthritis is complicated by the fact that not all individuals infected with B. burgdorferi develop arthritis. Additionally, Lyme arthritis manifests in different severities between affected individuals. It is known that an inflammatory response is initiated by B. burgdorferi infection and that inflammatory T cells contribute to the development of arthritis. However, the anti-inflammatory mechanisms that regulate the pathogenic T cells’ response are not entirely understood. Here, the hypothesis that a dysregulated immune response results in an excessive …

The Association Of Nurses’ Assessment And Certainty To Pain Management And Outcomes For Nursing Home Residents In Jordan, Mohammad Jamil Rababa

Theses and Dissertations

Despite advances in dementia care Pain in people with dementia is still under recognized, underestimated, and undertreated because of poor assessment, poor treatment, and factors relating to nurses’ critical thinking and decision-making skills. Unrelieved pain leads to many serious negative health outcomes in people with dementia. The purpose of the study was to examine temporally based relationships between change in behavior, the nurses’ level of certainty regarding pain, assessment scope and outcomes of pain and agitation. Relationship between severity of dementia, comorbid burden, ability to verbally self-report symptoms and patient outcomes of pain and agitation was also investigated.

A Convenient …

Is Parathyroid Hormone (Pth) Replacement Therapy Effective In Treating Patients With Hypoparathyroidism?, Kaidden G. Kelly

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Parathyroid Hormone (PTH) replacement therapy an effective treatment for patients with hypoparathyroidism?”

STUDY DESIGN: Review of a randomized control trial published in 2011, a prospective cohort study published in 2013, and a randomized crossover study published in 2012.

DATA SOURCES: All articles used were published in English, and were found in peer-reviewed journals using PubMed.

OUTCOMES MEASURED: The need to remove supplemental calcium from the diet, the amount PTH was used to maintain a normal range, and the method of PTH …

Conquering The Kitchen: Cooking And Older Adult Male Caregivers, Miranda Jenkins, George Kukich

Older Adult

Older adult men who have taken on an unfamiliar role as a caregiver find themselves at a loss with how to conduct meal preparation and cooking (Russell, 2007). The purpose of this study was to explore the effects of a specialized cooking class on the perceptions of older adult male caregivers. Method: This mixed method, retrospective study analyzed surveys from subjects who attended a cooking class designed specifically for male caregivers. Participants were 60 years of age or older and were required to be living in one of nine participating local counties. Results: The participants reported that the course expanded …

Nanoparticle Toxicity And Molecular Mechanisms In Fish: A Case Study With Silver Nanoparticles, Jiejun Gao

Open Access Dissertations

Nanoparticles (NPs) are widely used in a myriad of commercial and industrial products making their entry to the environment a likely event. NPs have unique physical-chemical properties that result from their small size and high surface area to volume ratio, making them highly reactive and potentially toxic. In Chapter 1, we summarize the effects and mechanisms of metal-based NPs on the vascular system. In vitro studies have shown that NPs are anti-angiogenic because they cause inflammation, oxidative stress, and apoptosis of endothelial cells resulting in increased permeability and decreased proliferation and migration. Whole animal studies examining the effects of NPs …

Ambient Ionization - Mass Spectrometry: Advances Toward Intrasurgical Cancer Detection, Alan Keith Jarmusch

Open Access Dissertations

My dissertation research has focused on the development of ambient ionization – mass spectrometry (MS) for clinical measurements, specifically intrasurgical cancer detection. The molecular differences between normal and cancerous tissue were detected via direct tissue analysis in vitro by touch spray ionization (TS) or by analyzing sectioned or smeared tissue using desorption electrospray ionization (DESI). The physical form of the tissue, e.g. in vitro sampling, sectioned, or smeared, was inconsequential in differentiating normal from cancerous tissue; however, the spectra acquired by TS and DESI differed due to differences in ionization processes. We envision that TS-MS and DESI-MS could impact diagnostic …

Gonadal Intersex In Teleosts: Mechanisms, Molecular Biomarkers And Diagnostic Assays, Ahmed M.E. Abdel-Moneim Mohamed

Open Access Dissertations

Natural and synthetic estrogenic and androgenic compounds are continuously released into aquatic ecosystems. Exposure of teleost fishes to these contaminants can negatively impact sex differentiation and reproductive output. Specifically, development of gonadal intersex in gonochoristic (fixed sex) fish species has been studied extensively in relation to exposure to this class of compounds. The main objectives of this dissertation were to: 1) conduct field and laboratory studies to investigate the molecular signaling pathways behind the development of gonadal intersex; and 2) establish molecular biomarkers and assays for testing the ability of environmental pollutants to develop this condition using a battery of …

Whole Genome Sequencing As A Tool For Identifying Phenotypic Properties And Underlying Genetic Mechanisms In Staphylococcus Pseudintermedius, Matthew C. Riley

Doctoral Dissertations

Staphylococcus pseudintermedius is a Gram-positive bacterial opportunistic pathogen commonly associated with dermal infections in canines, but capable of causing serious disease in other species. Reports of human infections caused by S. pseudintermedius along with an increase in resistance to multiple antibiotics highlights the importance of this organism. Whole genome sequencing can allow large scale investigation of genetic mechanisms underlying phenotypic properties that contribute to the expansion of successful S. pseudintermedius clonal lineages.

The increase in multidrug and methicillin-resistant S. pseudintermedius (MRSP) may result from horizontal transfer of genetic material between bacterial isolates, yet is thought to be rare in Staphylococci …

Sensitivity Analysis Of Geometry Changes In The Simulation Of Basilar Aneurysms, Paul Eserkaln

Theses and Dissertations

Computer simulation is a useful tool in the research and treatment of basilar aneurysms. Current technology allows researchers to create 3D models from cerebral vasculature in-vivo, allowing for the investigation of surgical options with minimal risk to the patient. The method used to construct these models overlooks smaller lateral arterial branches which are difficult to discern due to resolution limits of the imaging process. These lateral branches have minimal impact on the overall blood flow through the basilar artery, but they play a significant role in the health of the patient, so it is important to ensure sufficient blood will …

Determination Of Thermal Dose Model Parameters Using Magnetic Resonance Imaging, Christopher James Maclellan

Dissertations & Theses (Open Access)

Magnetic Resonance Temperature Imaging (MRTI) is a powerful technique for noninvasively monitoring temperature during minimally invasive thermal therapy procedures. When coupled with thermal dose models, MRTI feedback provides the clinician with a real-time estimate of tissue damage by functioning as a surrogate for post-treatment verification imaging. This aids in maximizing the safety and efficacy of treatment by facilitating adaptive control of the damaged volume during therapy. The underlying thermal dose parameters are derived from laboratory experiments that do not necessarily reflect the surrogate imaging endpoints used for treatment verification. Thus, there is interest and opportunity in deriving model parameters from …

Her4 Promotes A Stem-Like Phenotype In Osteosarcoma, Rocio K. Rivera-Valentin

Dissertations & Theses (Open Access)

Metastatic disease to the lungs is the primary cause of death for patients with pediatric osteosarcoma (OS). OS has a high degree of heterogeneity and genomic instability, making understanding the pathogenesis and drivers of metastasis of this disease challenging. In an effort to explain tumoral heterogeneity, the tumor initiating cell model (TIC) states that tumors are composed of cells that form the majority of the tumor and are terminally differentiated. This model however, attributes tumorigenesis, metastasis and chemoresistance to a distinct cell population with a stem-like phenotype that can be identified using selective markers. OS appears to follow this model …

The Association Between Known Risk Factors For Type 2 Diabetes, And The Body Mass Index Of Diabetic Adults, Faten Ahmed Almubarak

Graduate Theses and Dissertations

Diabetes mellitus (DM) has been a major research topic in scientific health studies. Diabetes is a chronic condition in which blood glucose levels are chronically elevated to more than 7.0 mmol/l in fasting plasma glucose test. The most common form of diabetes is Type 2 (TD2M). The International Diabetes Federation (2015) estimated the number of DM cases worldwide to be 415 million people in 2015. This number is predicted to increase by the year 2040, to 642 million people. The purpose of this study was to use the National Health Interview Survey (NHIS) data to identify the risk factors for …

The Role And Regulation Of Inhibitor Of Kappa B Kinase In The Impaired Monocyte Response., Norman James Galbraith

Electronic Theses and Dissertations

Trauma, major surgery and systemic infection can lead to a subsequent immunosuppressed state which can predispose patients to nosocomial infection and death. Approximately a sixth of patients will have impaired monocyte function, as determined by decreased HLA-DR expression or decreased TNF-α production in response to ex-vivo lipopolysaccharide (LPS) stimulation. This project aimed to develop an in-vitro model of impaired monocyte function using isolated monocytes from healthy volunteers, to study the effect of monocyte impairment on IκK signaling, and determine the role of IκK in the impaired monocyte response. These studies have provided the following results:

1. Monocytes treated with low dose …

Evaluating Cardiovascular Dysfunction During Increased Activity And Exercise Rehabilitation Following Incomplete Thoracic Spinal Cord Injury In The Adult Rat., Kathryn A. Harman

Electronic Theses and Dissertations

Spinal cord injury (SCI) results in whole-body dysfunction. While the majority of SCI research is focused on improving locomotor function after injury, cardiovascular (CV) disease continues to be the leading cause of morbidity in the chronic SCI patient population. The combination of injury-induced destruction of autonomic pathways, maladaptive plasticity within lumbosacral circuits, and the progressive decline in physical fitness contribute to the poor CV status of SCI individuals. Currently, there is little emphasis on implementing appropriately-timed acute rehabilitation techniques aimed to curtail maladaptive remodeling and improve CV outcomes. Furthermore, no pre-clinical or clinical studies have investigated the most appropriate time-course …

The Role Of Nicotine, A7 Nicotinic Acetylcholine Receptors And Extracellular Matrix Remodeling In Pulmonary Fibrosis., Glenn Ward Vicary

Electronic Theses and Dissertations

The median survival for idiopathic pulmonary fibrosis (IPF) patients from diagnosis is a dismal 3 years. This condition is characterized by pulmonary fibroproliferation and excess production and disordered deposition of extracellular matrix (ECM) proteins resulting in obliteration of the original tissue architecture, loss of lung function and eventual death due to respiratory failure. The main hindrance to the development of effective treatments against pulmonary fibrosis is the late detection of its progression and is often of unknown cause. Tobacco smoke represents the most important environmental factor linked to the development of pulmonary fibrosis, with over 60% of IPF patients current …

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical guidelines. Provider …

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus …

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in trauma …

Optimizing Anesthesia Providers’ Timing Of Administration Of Dexamethasone For The Prevention Of Post-Operative Nausea And Vomiting: Translating Clinical Guidelines Into Practice, Tanner Young Mixon

Doctoral Projects

Research has shown that post-operative nausea and vomiting (PONV) is a significant contributing factor to extended recovery times and unwanted hospital admissions following ambulatory surgery. The purpose of this DNP project was to assess current practice regarding administration of dexamethasone for the prevention of PONV, provide information based on best practice guidelines, and assess willingness to change practice based on the guidelines set forth by the Society for Ambulatory Anesthesia (SAMBA). Administration of dexamethasone is aimed at decreasing the incidence of PONV, optimizing PACU times, and increasing patient satisfaction regarding perioperative care.

An electronic presentation and survey were emailed to …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

Evaluating The Likelihood Of Use Of Bispectral Index Guided Anesthesia As A Strategy To Reduce Postoperative Delirium In Surgical Patients 65 Years Of Age Or Older, Simon Jack Gibson

Doctoral Projects

Postoperative delirium (POD) is the most common postoperative complication in the elderly, accounting for approximately $164 billion in costs per year in the United States (Inouye, Westendorp, & Saczynski, 2014, p. 911). This complication occurs in as many as 50% of elderly patients, but can be prevented as much as 40% of the time (Inouye et al., 2014). The use of processed encephalographic monitoring, such as Bispectral Index (BIS) monitoring, to guide anesthetic dosage is the single intraoperative intervention with enough evidence to support it as a recommendation for use to reduce POD (American Geriatrics Society, 2015). There were two …

Is Current Evidence That Avoidance Of Inhalation Agents And Opioids May Decrease Metastasis Strong Enough For Crnas To Show A Willingness To Change Practice?, Michael Wesley Tillman

Doctoral Projects

Metastasis following the surgical resection of primary site breast cancer is a medical issue, which plagues mastectomy patients. The intention of this project was to synthesize current literature in order to make a presentation and disseminate it to Certified Registered Nurse Anesthetists (CRNAs) in southern Mississippi and assess the providers' willingness to change practice. CRNAs took part in a Qualtrics survey after viewing a PowerPoint presentation of evidence regarding anesthesia and metastasis. The presentation illustrated the anesthetic techniques and pharmacological agents utilized, which either mitigate or potentiate a patient's risk for metastasis. The survey assessed for a willingness to change …